Shoulder Replacement Surgery

If you suffer from debilitating shoulder pain, you know how much it can limit your movement and ability to perform every day activities such as reaching into a cupboard, dressing, and bathing. Your shoulder may make grinding or grating noises when you move it. It might even catch or lock up. Pain in your shoulder could become severe enough to keep you awake at night.

In general, severe shoulder damage that results from arthritis or injury is initially treated with rest, exercise and medications for pain. Self-help measures, such as applying moist heat or using an ice pack after strenuous exercise, may ease mild pain. In some cases, physical therapy may be helpful. And for some patients, cortisone injections into the shoulder joint may provide temporary pain relief. When these measures no longer help, you may begin to consider having shoulder replacement surgery.

Diagnostic Tests

To help determine if you are a candidate for shoulder replacement surgery, your physician may ask you questions about your shoulder pain and how it affects movement and everyday activities. Your doctor may also perform a physical examination to assess your range of motion, the strength and stability of your shoulder, and any tenderness or swelling. Diagnostic tests, to determine the location and severity of damage in your shoulder joint, may include, x-rays, MRIs or CT scans. Source: American Academy of Orthopedic Surgeons

Shoulder Replacement at Baptist

With the Joint Replacement Program at Baptist, patient education and support begins at the time the surgery is scheduled, and continues through the hospital stay and the recovery process at home. The patient's family members and primary care physician-or hospitalist on staff at Baptist-are involved in the patient's care from preadmission through discharge. This constant communication contributes to quality care and good patient experiences, which are our priority at Baptist.

Orthopedic Surgeons at Baptist

The first step in having shoulder replacement surgery at Baptist is being seen by one of our physicians. All orthopedic surgeons on staff at Baptist are board certified, and many have subspecialty training within the field of orthopedic surgery. Each year, our physicians perform more than 1,100 joint replacement surgeries.

Types of Shoulder Replacement

Total Shoulder Replacement

The shoulder joint is a ball-and-socket joint consisting of three bones: three main parts: the upper arm bone (humerus), shoulder blade (scapula) and collarbone (clavicle). The ball at the top end of the arm bone fits into the small socket of the shoulder blade to form the shoulder joint.

The smooth, durable surface of articular cartilage covers the head of the arm bone and the socket area of the scapula. This cartilage cushions the joint and allows ease of movement. The rotator cuff is a group of muscles and tendons that attach your upper arm to your shoulder blade, and allow you to lift your arm, reach overhead, and make circular movements such as throwing or swimming.

During a total shoulder replacement, an orthopedic surgeon removes only the damaged cartilage and bone of the shoulder joint, and then positions a new prosthetic implant to restore the shoulder's normal anatomy. The procedure takes about two hours to perform.

A standard total replacement consists of two parts: a highly polished metal ball attached to a stem that is inserted into the arm bone; and a plastic socket that is implanted into the socket. In some cases, surgical cement may be used to secure the artificial joint to the natural bone. Depending on the condition of the shoulder, your surgeon may replace only the ball if the socket is normal. Patients with intact rotator cuff tendons are generally good candidates for conventional total shoulder replacement.

Reverse Shoulder Replacement

Patients who do not have a functioning rotator cuff are not candidates for traditional shoulder replacement surgery. For these patients, the reverse shoulder replacement surgery may be an option. This implant reverses the normal anatomy of the shoulder joint--the socket and metal ball are switched.

In a standard shoulder replacement, the socket of the scapula is resurfaced and the ball at the top of the arm bone is replaced. In the reverse shoulder procedure, the ball is placed on the scapula, and the socket is created at the top of the arm bone. This allows the deltoid muscle, instead of the nonfunctioning rotator cuff, to lift the arm.

The reverse procedure may also be an option for patients who had previous shoulder replacement surgery that failed. A standard shoulder replacement can fail for many reasons, which usually results in implant loosening and significant bone loss of the scapula and arm bone. Because of this bone loss, the standard shoulder replacement usually cannot be repeated.

Pain after Surgery

Baptist's Joint Replacement program focuses on pain management, recovery and an early return to normal activities. To help control pain after surgery, patients receive a nerve block that provides pain relief for 12 hours post surgery. This prevents the patient from experiencing most of the acute post operative pain. For the first 24 hours following surgery, most patients are on pain medication delivered via IV. After that point, if possible, most patients are transitioned to oral pain medications. In all cases, pain medication is individualized for each patient to minimize discomfort.

Shoulder Replacement Complications

Although they are very rare, complications may include infection, bleeding, instability, tearing of the rotator cuff, fracture and loosening of the implant. The most common complication, when it occurs, is instability. Complication rates are higher in patients who are being revised from a failed standard total replacement to a reverse.

Recovery and Return to Normal Activities

Most patients can resume normal light activities within six weeks following surgery. It takes about 12 to 16 weeks after surgery to resume all activities with no restrictions. It's common to experience some discomfort with activity and at night for several weeks. At Baptist, recovery begins right away with group inpatient rehab, held on the Joint Replacement Unit. Therapists get patients up and moving as soon as possible to restore movement and function.

Outpatient Physical Therapy

After discharge from the hospital, your recovery will continue under the guidance of therapists in our outpatient physical therapy program. Baptist has locations for outpatient therapy throughout the metro Jackson area, so you can get care in a facility that is most convenient to you.

If you would like to have shoulder replacement surgery at Baptist, you can use our online form to request a referral to one of our physicians.